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Baby Aspirin?

We’ve addressed the controversial issue of taking ibuprofen and other NSAIDS before workouts and races, but what about aspirin?

There is a theory emerging about sudden cardiac death (the cause of several deaths during the recent Detroit Marathon) being caused by an interaction of muscular breakdown and plaque – something that could, in theory, be prevented by aspirin.

At this point it is all theory, and the number of running deaths is extremely minimal when you consider the millions of people who run marathons, but it is still a fascinating topic and worth a read.

One thought on “Baby Aspirin?”

Aspirin use for primary prevention of sudden cardiac death in young athletes without traditional cardiac risk factors is unproven and not without potential risks, including intracranial hemorrhage and gastrointestinal bleeding. I would urge athletes considering this to check with their doctors first.

It is true that aspirin reduces platelet activation, which causes blood clots. Aspirin use reduces myocardial infarction risk by about 25-33% in patients with KNOWN coronary artery disease. It has never been shown to have benefit in patients WITHOUT KNOWN coronary artery disease. Furthermore, the majority of sudden cardiac deaths in young athletes is due to hypertrophic cardiomyopathy, anomalous coronary arteries, and other structural heart defects – none of which can be prevented with aspirin. If the risk of sudden death in marathoners overall is 1 in 50,000, and only a tiny fraction of these deaths are in young persons without the above conditions I listed in the previous sentence, you would have to treat hundreds of thousands of young runners with baby aspirin in order to prevent one cardiac death. The risks involved with taking aspirin are rare but nonzero, and it is unknown in the medical profession whether doing this saves more lives than it costs.

In conclusion, on the basis of currently available data, aspirin cannot be recommended at this time to prevent sudden cardiac death in young healthy runners with no known cardiac risk factors. Older runners (e.g. men over 40, women after menopause) and people with hypertension, high cholesterol, diabetes, known coronary artery disease, etc., might benefit from aspirin, but should check with their doctors before doing so.